Abstract | November 8, 2021

Evaluation of Comorbidities and Biomarkers to Predict Hospital Length-of-Stay and Mortality in VTE Patients

Presenting Author: Kesany C Boupapanh, BS, Medical Student, 4th Year, Tulane University School of Medicine, New Orleans, LA, New Orleans, Louisiana

Coauthors: Kesany Boupapanh, BS, Medical Student, Tulane University School of Medicine, New Orleans, LA; Melissa Infosino, BA, Medical Student, Tulane University School of Medicine, New Orleans, LA; Yichi Zhang, BS, Medical Student, Tulane University School of Medicine, New Orleans, LA; Jessica Shank, MD, Assistant Professor, Gynecologic Oncology, Tulane University School of Medicine, New Orleans, LA.

Introduction: Venous thromboembolism (VTE) and its associated complications are a rapidly rising cause of hospitalization and mortality in the United States. The clinical outcomes of VTE are influenced by patients’ medical comorbidities and certain coagulation and inflammatory biomarkers. We investigate these associations in an ethnically diverse city with a minority-majority patient population.

Methods: A retrospective analysis was performed on patients diagnosed with a VTE from January 2019 to July 2020 at an academic medical institution. Patient demographic information, past medical history, laboratory values, and clinical outcomes were collected. Statistical analysis was performed using IBM SPSS 27 with a 2-tailed Pearson Correlation test and Receiver-Operator Curve (ROC).

Results: A total of 293 patients with a VTE diagnosis were included (53% Female, 57% African American, Average age=57.2±14.2, Average BMI = 28.8±7.1). The most common medical comorbidities were hypertension (57%), diabetes mellitus (28%), hyperlipidemia (25%) and heart failure (14%). Various coagulation and inflammatory biomarkers were collected, the average values are: WBC (9.01), Hct (28.14), Plt (186.98), PT (13.18), INR (1.24), PTT (38.13), CRP (332), Lactic Acid (27.89). Average length of hospital stay was 10.5 days and mortality rate was 3.66%. Hypertension (r=0.27, p=0.037) and acute coronary syndrome (r=0.539, p<0.001) were correlated with longer hospital length-of-stay. No comorbidities were significantly correlated with mortality. Among coagulation and inflammatory biomarkers, Hct was negatively correlated with length-of-stay (r=-0.437, p<0.001) and negatively correlated with mortality (r=-0.343, p=0.002). Interestingly, Plt count (r=-0.339, p=0.002) and WBC count (r=-0.227, p=0.047) were also negatively correlated with mortality.

Conclusion: Certain medical comorbidities and coagulation/inflammatory biomarkers may be useful in predicting length-of-stay and mortality of VTE patients. Here, we find that in addition to hypertension and acute coronary syndrome, Hct, Plt and WBC levels can all be useful in determining VTE prognosis. Underlying mechanisms should be further evaluated to substantiate these relationships.

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